WASHINGTON – Co-payments for outpatient medicines prescribed through Department of Veterans Affairs (VA) medical facilities will rise by $1, according to an announcement today by VA. The $1 increase for a 30-day supply of prescription drugs will take effect on January 1, 2006, the first change in VA prescription drug co-payments in four years.
"Through sound management practices, efficient pharmacy operations and price negotiations that put veterans first, VA has been able to contain prescription drug costs,” said the Honorable R. James Nicholson, Secretary of Veterans Affairs, noting that co-payments paid by veterans will still be lower than similar expenses in the private sector.
The increase to $8 from $7 for a 30-day supply of prescription drugs is required by federal law, which bases VA's co-payments for outpatient prescriptions on increases in the Medical Consumer Price Index.
The $1 increase will not affect veterans who have an injury or illness connected with their military service resulting in a 50 percent or greater disability. Also known as “Priority Group 1” veterans, these patients will see no change in their current prescription drug benefit, Nicholson said.
Other veterans with less pronounced service-connected ailments – those classified as Priority Groups 2 through 6 – will see their prescription drug co-pays rise by $1, but their annual out-of-pocket expenses for VA medicine will remain capped. The new cap will rise to $960 per year, up $120 from the previous level. This means veterans in Priority Groups 2 through 6 will pay no more than $960 annually for VA outpatient medicine.
Veterans who have no injury or illness related in any way to their prior military service – referred to as Priority Groups 7 and 8 – will also see their co-payments increase, but there is no cap on annual payments for outpatient medicine.
Not all prescription drugs will be subject to the $1 increase. Outpatient medications not subject to co-payments include:
· Medication for treatment of a service-connected disability;
· Medication for a veteran who has a service-connected disability of 50 percent or more;
· Medication for a veteran disabled by 50 percent or more for unemployability;
· Medication for a veteran whose annual income does not exceed the amount of VA pensions;
· Medications for health problems that may be linked to Agent Orange for Vietnam veterans, to radiation exposure, to undiagnosed illnesses of Persian War veterans, or for new veterans within two years of discharge after serving in a combat theater.
